Postgraduate internship to be abolished? Environment warns of impact

The OZZL Residents' Association has been sounding the alarm for years about the deteriorating quality of medical education in Poland. Problems with the realization of educational outcomes, overloaded medical faculties, or residents' difficulties in accessing procedures during specialization - these are just some of the challenges faced by the young doctors' community. In this context, the organization expresses "deep concern and firm opposition" to plans to abolish or shorten postgraduate internships.

Practical VI year will not replace internship

As the residents point out, the argument about the "practical VI year" - touted as an alternative to internship - is not supported by the facts. To assess the actual preparation of graduates, the Residents' Agreement decided to take part in a survey examining the extent of mastery of key medical procedures.

The survey included 720 fifth- and sixth-year students from 22 universities and doctors in training (as of May 5, 2025). Respondents indicated whether the procedure was discussed theoretically, presented in practice, and whether they had the opportunity to perform it themselves. Only basic activities, necessary in daily clinical practice, were analyzed.

Disturbing results: most students failed to perform basic procedures

The survey data show significant gaps in practical preparation:

• Male bladder catheterization was not performed by 56% of respondents,
• In women, this percentage was 68%,
• arterial blood draws were not performed by 76% of respondents,
• 61% have not had surgical suturing,
• The per rectum examination was not performed by 54%,
• 61% did not take swabs,
• 87% have never explored the stomach.

Moreover, the larger the clinical group, the less opportunity to practice the procedures. In groups of five or more, as many as 79.1% of students had never drawn arterial blood, while in groups of up to four, the percentage dropped to 51.9%. Residents emphasize that the surge in the number of medical students further limits access to practice.

Internship gives real opportunity to work with patients

The results for doctors in postgraduate training are quite different. During the 13 months, interns are much more likely to perform all the procedures studied. They no longer work in large clinical groups, they have individual contact with patients, which enables them to gain practical competence.

An example: bladder catheterization in a man was performed by 56% of the trainees, compared to about one-third among students.

Residents emphasize: although practical training still needs to be improved, the abolition of the internship means that young doctors will be fully licensed to practice with significantly less experience than before.

Consequences for the system: recruitment chaos and lost time in choosing a specialty

Internship is also a period of reviewing career choices. It is only then that many young doctors gain real knowledge of the day-to-day work of their respective specialties.

Eliminating the internship would also result in the accumulation of two vintages - those completing the internship and graduates who would enter the system without having completed it. This would mean even more difficult access to residency spots.

Residents: let's improve education first, then talk about changes

According to PR OZZL, a prerequisite for any discussion of abolishing internships is that the final years of study must first be transformed into genuinely practical ones. This means the necessity of:

• Reducing the size of clinical groups to two in the final year,
• Provide real access to perform procedures,
• Introduce a reliable assessment of the skills acquired.

"Since this condition is not met, we strongly oppose the abolition or shortening of postgraduate internships," the residents conclude.

All data from the survey - including gender disparities in access to procedures - were published in the paper "Gender-based disparities in self-reported procedural experience: a cross-sectional survey of medical students in Poland."

Source: OZZL Residents' Agreement